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Patterns of cancer screening in primary care from 2005 to 2010
Author(s) -
Martires Kathryn J.,
Kurlander David E.,
Minwell Gregory J.,
Dahms Eric B.,
Bordeaux Jeremy S.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28403
Subject(s) - medicine , mammography , rectal examination , papanicolaou stain , family medicine , breast cancer , cancer screening , breast cancer screening , cancer , gynecology , medicaid , socioeconomic status , prostate cancer , obstetrics , health care , population , environmental health , cervical cancer , economics , economic growth
BACKGROUND Cancer screening recommendations vary widely, especially for breast, prostate, and skin cancer screening. Guidelines are provided by the American Cancer Society, the US Preventive Services Task Force, and various professional organizations. The recommendations often differ with regard to age and frequency of screening. The objective of this study was to determine actual rates of screening in the primary care setting. METHODS Data from the National Ambulatory Medical Care Survey were used. Only adult visits to non–federally employed, office‐based physicians for preventive care from 2005 through 2010 were examined. Prevalence rates for breast, pelvic, and rectal examinations were calculated, along with the rates for mammograms, Papanicolaou smears, and prostate‐specific antigen tests. Factors associated with screening, including age, race, smoking status, and insurance type, were examined using t tests and chi‐square tests. RESULTS In total, 8521 visits were examined. The rates of most screening examinations and tests were stable over time. Clinical breast examinations took place significantly more than mammography was ordered (54.8% vs 34.6%; P < .001). White patients received more mammography ( P = .031), skin examinations ( P < .010), digital rectal examinations ( P < .010), and prostate‐specific antigen tests ( P = .003) than patients of other races. Patients who paid with Medicare or private insurance received more screening than patients who had Medicaid or no insurance ( P < .010). CONCLUSIONS Current cancer screening practices in primary care vary significantly. Cancer screening may not follow evidence‐based practices and may not be targeting patients considered most at risk. Racial and socioeconomic disparities are present in cancer screening in primary care. Cancer 2014;120:253–261 . © 2013 American Cancer Society .